Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this issue. I am responding on behalf of my colleague, the Minister of State at the Department of Health with responsibility for disability, Deputy Rabbitte. I know that, as part of Deputy Moynihan's work on the disability committee, he has been very active in promoting this and other related areas. It is very important the committee continues to highlight his work.

I am glad to take this opportunity to set out the position regarding the status of the national policy and strategy for the provision of neurorehabilitation services in Ireland. Such services play a critical role in supporting recovery and in maximising the ability of those with neurological conditions at inpatient and community level. Programme for Government: Our Shared Future includes a commitment to advance neurorehabilitation services in the community. The HSE is leading the implementation of the recommendations of the national policy and strategy. The HSE neurorehabilitation implementation framework, From Theory to Action, was launched in February 2019. The framework outlines a ten-step approach that will see each HSE CHO introducing local implementation teams to oversee and guide the implementation process.

The overarching aim of the strategy is to develop neurorehabilitation services to improve patient outcomes by providing safe, high-quality, person-centred neurorehabilitation at the lowest appropriate level of complexity. This must be integrated across the care pathway and provided as close to home as possible or in specialist centres where necessary. This objective represents a significant change in practice from the current model that sees specialist rehabilitation services centralised in one location, namely, the National Rehabilitation Hospital. The new model will see the introduction of a multi-tiered system, with access to services based on clinically assessed need. Services would work together across organisational boundaries, with patients seamlessly moving across the continuum of care based on their needs. These services should be configured into population-based managed clinical rehabilitation networks. The rehabilitation network, while an effective model in several European countries, is a new concept in Ireland. Managed clinical rehabilitation networks are recognised as having the potential to bring together an appropriate range of primary, secondary and tertiary services to ensure equitable provision of high-quality and clinically effective services.

Considering the scale of the fundamental change proposed, the HSE is advancing a demonstrator project across CHO 6 and CHO 7. The focus of this project is to develop post-acute and community neurorehabilitation services in both these areas. Funding for the demonstrator pilot scheme became available from the Sláintecare redesign fund for quarter 4 of 2020, with full-year funding of €2.29 million available for 2021. This funding is available on an ongoing basis and includes provision for the establishment of ten additional inpatient beds in Peamount Healthcare. The implementation of the ten-bed neurorehabilitation unit in Peamount has improved timely and early access to post-acute specialist rehabilitation services for patients with complex disability.

This development is part of the overall HSE implementation plan for neurorehabilitation and the new beds introduce in the order of 3,500 additional specialist rehabilitation bed days per annum into the system. With average length of stay of approximately 90 days, this means that about 40 patients per annum will have their rehabilitation needs met in an appropriate setting outside of acute hospitals. The HSE has confirmed that work is under way to establish community neurorehabilitation teams in the demonstrator project areas. Once these community teams are in place, the HSE will have all the elements of the basic construct of a full managed clinical rehabilitation network across the demonstrator project.

See this speech in context